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Published on: July 1, 2018

Unusual CNS infection from a subtorcular dermal sinus

P M Kanev1, J C Salazar

  • 1Department of Pediatric Neurosurgery, Connecticut Children's Medical Center, Hartford, CT, USA. pkanev@ccmckids.org

Acta Paediatrica (Oslo, Norway : 1992)
|November 17, 2009
PubMed
Abstract

Insights

A toddler

Area of Science:

  • Pediatric Neurosurgery
  • Infectious Diseases
  • Medical Imaging

Background:

  • Dermal sinus tracts are congenital anomalies that can lead to central nervous system (CNS) infections.
  • Hydrocephalus and increased intracranial pressure are serious complications of CNS infections.

Observation:

  • A 14-month-old toddler presented with symptoms of hydrocephalus and raised intracranial pressure.
  • Imaging revealed a posterior fossa dermoid mass associated with a previously unrecognized dermal sinus tract.
  • Cerebrospinal fluid (CSF) and subdural empyema cultures were positive for Staphylococcus aureus and Escherichia coli.

Findings:

  • This case represents the first reported instance of a dermoid mass and CNS infection with Staphylococcus aureus and Escherichia coli originating from a dermal sinus tract.
  • The unusual pathogens highlight the importance of considering underlying anatomical abnormalities in CNS infections.

Implications:

  • Children with CNS infections involving unusual pathogens require thorough evaluation for congenital anomalies like dermal sinus tracts.
  • Early identification of dermal sinus tracts can prevent severe neurological complications.
  • This case underscores the need for a multidisciplinary approach in diagnosing and managing complex pediatric neurosurgical cases.

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